96-06: Mandated Immunization Coverage for Children

The Missouri legislature recently enacted House Bills Nos. 904, 788 and 966 (HB 904),
which will become effective on August 28, 1996.

This legislation requires health plans to provide coverage for immunizations of a child
from birth to five years of age. No deductible or copayment is to apply.

As required by HB 904, the Missouri Department of Health has promulgated an emergency
regulation, 19 CSR 20-28.060,
setting forth the immunizations that must be covered.

This legislation is broadly worded to apply to all policies, contracts or arrangements
issued or provided by insurers, health services corporations, health maintenance
organizations, self-funded groups to the extent not preempted by federal law, and all
managed care delivery entities of any type or description.

The language of HB 904 does not limit its applicability to policies or contracts issued
in Missouri. Therefore, this mandate applies to any health plan providing coverage for a
child in Missouri that is issued, continued or renewed on or after August 28, 1996. Plans
issued on or after the effective date must comply immediately. Plans currently in
existence must be brought into compliance no later than the first
policy/contract/arrangement anniversary date on or after August 28, 1996.